Role of exercise on visceral adiposity after spinal cord injury: a cardiometabolic risk factor

Jacob A. Goldsmith, Areej N. Ennasr, Gary J. Farkas, David R. Gater, Ashraf S. Gorgey

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations


Purpose: Visceral adipose tissue (VAT) is associated with cardiometabolic disease risk in able-bodied (AB) populations. However, the underlying mechanisms of VAT-induced disease risk are unknown in persons with spinal cord injury (SCI). Potential mechanisms of VAT-induced cardiometabolic dysfunction in persons with SCI include systemic inflammation, liver adiposity, mitochondrial dysfunction, and anabolic deficiency. Moreover, how exercise interventions impact these mechanisms associated with VAT-induced cardiometabolic dysfunction are still being explored. Methods: A search for relevant scientific literature about the effects of exercise on VAT and cardiometabolic health was conducted on the PubMed database. Literature from reference lists was also included when appropriate. Results: Both aerobic and resistance exercise training beneficially impact health and VAT mass via improving mitochondrial function, glucose effectiveness, and inflammatory signaling in SCI and AB populations. Specifically, aerobic exercise appears to also modulate cellular senescence in AB populations and animal models, while resistance exercise seems to augment anabolic signaling in persons with SCI. Conclusions: The current evidence supports regular engagement in exercise to reduce VAT mass and the adverse effects on cardiometabolic health in persons with SCI. Future research is needed to further elucidate the precise mechanisms by which VAT negatively impacts health following SCI. This will likely facilitate the development of rehabilitation protocols that target VAT reduction in persons with SCI.

Original languageEnglish (US)
Pages (from-to)2143-2163
Number of pages21
JournalEuropean Journal of Applied Physiology
Issue number8
StatePublished - Aug 2021


  • Aerobic exercise training
  • Body composition
  • Cardiometabolic disorders
  • Inflammation
  • Resistance training
  • Spinal cord injury
  • Subcutaneous adipose tissue
  • Visceral adipose tissue

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Public Health, Environmental and Occupational Health
  • Physiology (medical)


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